outbreak

NEW YORK — No quick dispatching of disease investigators. No televised news conference to inform the public. No timely health alerts to doctors.

In the midst of a hantavirus outbreak that involves Americans and is making headlines around the world, the U.S. government’s top public health agency, the Centers for Disease Control and Prevention, has been uncharacteristically missing in action, according to a number of experts.

To President Trump, “we seem to have things under very good control,” as he told reporters Friday evening.

To experts, the situation aboard a cruise ship has not spiraled because, unlike COVID-19 or measles or the flu, hantavirus does not spread easily. It has been health experts in other countries, not the United States, who have been dealing primarily with the outbreak in the last week.

“The CDC is not even a player,” said Lawrence Gostin, an international public health expert at Georgetown University. “I’ve never seen that before.”

Not until late Friday did CDC actions accelerate.

Health officials confirmed the deployment of a team to Spain’s Canary Islands, where the ship was expected to arrive early Sunday local time, to meet the Americans onboard. They said a second team will go to Offutt Air Force Base in Nebraska as part of a plan to evacuate U.S. passengers from the ship to a University of Nebraska quarantine center for evaluation and monitoring. Also, the CDC issued its first health alert to U.S. doctors, advising them of the possibility of imported cases.

At their first briefing, held Saturday by telephone only for invited reporters, officials pledged to be transparent in updating the public but said the media could not cite the speakers by name under rules set by aides to Health Secretary Robert F. Kennedy Jr. They did not directly answer a question about whether the U.S. passengers could leave the university medical facility when they wanted.

The CDC’s diminished role in this outbreak is an indicator the agency is no longer the force in international health or the protector of domestic health that it once was, some experts said.

The hantavirus outbreak is “a sentinel event” that speaks to “how well the country is prepared for a disease threat. And right now, I’m very sorry to say that we are not prepared,” said Dr. Jeanne Marrazzo, chief executive officer of the Infectious Diseases Society of America.

How the outbreak unfolded

Early last month, a 70-year-old Dutch man developed a feverish illness on a cruise ship traveling from Argentina to Antarctica and some islands in the South Atlantic. He died less than a week later. More people became sick, including the man’s wife and a German woman who both died.

Hantavirus was first identified as a cause of sickness of one of the cases on May 2. The World Health Organization swung into action and by Monday was calling it an outbreak. About two dozen Americans were on the ship, including about seven who disembarked last month and 17 who remained on board.

It’s WHO taking center stage

For decades, the CDC partnered with the WHO in such situations. The CDC acted as a mainstay of any international investigation, providing staff and expertise to help unravel any outbreak mystery, develop ways to control it and communicate to the public what they should know and how they should worry.

Such actions were a large reason why the CDC developed a reputation as the world’s premier public health agency.

But this time, the WHO has been center stage. It made the risk assessment that has told people the outbreak is not a pandemic threat.

“I don’t think this is a giant threat to the United States,” said Jennifer Nuzzo, director of Brown University’s Pandemic Center. But how this situation has played out “just shows how empty and vapid the CDC is right now,” she said.

Tumult under Trump

The current situation comes after 16 tumultuous months during which the Trump administration withdrew from the WHO, has restricted CDC scientists from talking to international counterparts at times and embarked on a plan to build its own international public health network through one-on-one agreements with individual countries.

The administration has laid off thousands of CDC scientists and public health professionals, including members of the agency’s ship sanitation program.

As this was playing out, Kennedy said he was working to “restore the CDC’s focus on infectious disease, invest in innovation, and rebuild trust through integrity and transparency.”

Waiting to hear from the CDC

The CDC has not been completely silent on hantavirus.

The agency on Wednesday issued a short statement that said the risk to the American public is “extremely low,” and described the U.S. government as “the world’s leader in global health security.”

Said Nuzzo: “Not only was that not helpful, it actually does damage because a core principle of public health communications is humility.”

The CDC’s acting director, Dr. Jay Bhattacharya, posted a message on social media that the agency was lending its expertise in coordinating with other federal agencies and international authorities. Arizona officials this week said they learned from the CDC that one of the Americans who left the ship — a person with no symptoms and not considered contagious — had already returned to the state. WHO officials said the CDC has been sharing technical information.

The CDC also is “monitoring the health status and preparing medical support for all of the American passengers on the cruise,” Bhattacharya wrote.

But federal health officials have mostly been tight-lipped, declining interview requests.

COVID-19 comparison

In interviews this week, some experts made a comparison with a 2020 incident involving the Diamond Princess, a cruise ship docked in Japan that became the setting of one of the first large COVID-19 outbreaks outside China.

The CDC sent personnel to the port, helped evacuate American passengers, ran quarantines, shared genetic data on the virus, coordinated with the WHO and Japan, held public briefings and rapidly published reports “that became the world’s reference data on cruise ship COVID transmission,” said Dr. Tom Frieden, a former CDC director.

Some aspects of the international response to the Diamond Princess were criticized, and it did not halt the outbreak or stop COVID-19’s spread across the world. But some experts say it was not for the CDC’s lack of trying.

“The CDC was right on top of it, very visible, very active in trying to manage and contain it,” Gostin said, while the agency’s work now is delayed and subdued.

Instead of working with nearly all of the world’s nations through the WHO, the Trump administration has pursued bilateral health agreements with individual nations for information sharing, public health support, and what it describes as “the introduction of innovative American technologies.” Roughly 30 agreements are currently in place.

That’s not sufficient, Gostin said. “You can’t possibly cover a global health crisis by doing one-on-one deals with countries here and there,” he said.

Stobbe writes for the Associated Press. AP writers Ali Swenson in New York, Darlene Superville in Washington and Susan Montoya Bryan in Albuquerque contributed to this report.

The island is a popular holiday destination for Brits

The World Health Organisation (WHO) has moved to reassure concerned residents in Tenerife that they will not come into contact with passengers from a hantavirus-affected cruise ship due to arrive on the island. Nearly 1million people call the island home, which also serves as a major holiday destination for British tourists and visitors from across Europe.

The UN health body confirmed there had been six cases of hantavirus linked to the MV Hondius vessel, with four patients currently receiving hospital treatment. It revealed that a total of eight cases, including three fatalities, had been recorded — though one suspected case has since been ruled out after returning a negative hantavirus test.

Around 22 British passengers and crew members aboard the ship are due to arrive in Tenerife on Sunday, with plans to fly them back to the UK on the same day. Representatives from the UK Health Security Agency (UKHSA) and the Foreign Office will meet the MV Hondius when it arrives in Spain’s Canary Islands, with British nationals on board undergoing hantavirus testing before disembarking.

Those who test negative and show no symptoms will be transported directly to a specially arranged repatriation flight with medical staff on board. British citizens returning home will be required to self-isolate for 45 days and will be prohibited from using public transport to reach their residences. The WHO confirmed on Saturday that no symptomatic passengers were currently aboard the vessel. In a letter to the residents of Tenerife, WHO director-general Dr Tedros Adhanom Ghebreyesus acknowledged locals were “worried”.

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The Ethiopian public health official described the virus as “serious” but stressed the outbreak was “not another Covid” and the “current public health risk from hantavirus remains low”.

He explained: “Spain’s authorities have prepared a careful, step-by-step plan: passengers will be ferried ashore at the industrial port of Granadilla, far from residential areas, in sealed, guarded vehicles, through a completely cordoned-off corridor, and repatriated directly to their home countries.

“You will not encounter them. Your families will not encounter them. Nearly 150 people from 23 countries have been at sea for weeks, some of them grieving, all of them frightened, all of them longing for home. Tenerife has been chosen because it has the medical capacity, the infrastructure, and the humanity to help them reach safety.”

Two British men are currently being treated for hantavirus in the Netherlands and Johannesburg, South Africa, while a third British man with symptoms is being cared for on the isolated South Atlantic island of Tristan da Cunha. The Foreign Office confirmed that a total of 30 passengers and crew aboard the MV Hondius are British nationals, with 22 still remaining on the vessel. The outbreak has been linked to a birdwatching trip in Argentina, which two of the passengers attended prior to embarking on the ship.

Three of six passengers who fell ill from suspected rodent-transmitted virus have died, and one is in intensive care, the WHO says.

Three people have died on a cruise ship in the Atlantic, with at least one confirmed to have suffered from hantavirus, a rare disease transmitted to humans from rodents.

Health authorities are now investigating a suspected outbreak of the virus on the MV Hondius, which is sailing from Ushuaia in Argentina to Cape Verde.

In a statement on Sunday, the World Health Organization said that one case had been confirmed and at least five other passengers were suspected of being infected.

“Of the six affected individuals, three have died, and one is currently in intensive care in South Africa,” WHO said in a statement.

“Detailed investigations are ongoing, including further laboratory testing and epidemiological investigations. Medical care and support are being provided to passengers and crew. Sequencing of the virus is also ongoing.”

WHO added that it was “facilitating coordination” between countries to evacuate the two other passengers showing symptoms of the infection.

Hantavirus, a rare disease transmitted to humans through the droppings or urine of infected rodents, can be fatal in severe cases and cause hemorrhagic fever.

Infected couple among casualties

South Africa’s National Department of Health said earlier on Sunday that there had been an outbreak of a “severe acute respiratory illness”, which had killed at least two people, and that a third person was in intensive care in Johannesburg, according to the AFP news agency.

The ministry’s spokesperson, Foster Mohale, confirmed that the patient being treated in Johannesburg tested positive for hantavirus.

A 70-year-old was the first to develop symptoms. He died on the ship, with his body now being held on the island of Saint Helena, a British territory in the South Atlantic, the spokesman said.

The patient’s 69-year-old wife also fell sick and was evacuated to South Africa, where she died in a Johannesburg hospital, he added.

Mohale told AFP that authorities have not confirmed the nationalities of the deceased. But the person in intensive care was reported by AFP to be a 69-year-old Briton.